肥胖型多囊卵巢综合征并发妊娠期高血压/子痫前期风险因素的研究

目的探讨肥胖型多囊卵巢综合征(PCOS)患者并发妊娠期高血压/子痫前期(PIH/PE)的风险因素。方法对PCOS合并不孕患者通过促排卵成功单胎妊娠的妇女进行前瞻性队列研究,随访至产后12周。从孕前的临床体征评分、内分泌及代谢状态中筛选出PCOS并发PIH/PE的风险因素。结果本研究共纳入促排卵受孕的PCOS患者92例,其中肥胖型和非肥胖型分别为38例和54例,并发PIH/PE分别为11例和6例,发病率分别为28.9%和11.1%(P0.05)。Logistic回归多因素分析显示肥胖型PCOS患者并发PIH/PE的风险因素为血性激素结合球蛋白(SHBG)(OR=0.975,P0.05),是唯一的独立风险因子;受试者工作特征(ROC)曲线分析孕前SHBG和腰臀比(WHR)对肥胖型PCOS患PIH/PE的预测价值分别为0.883及0.775(P均0.05)。结论肥胖型比非肥胖型PCOS患者更易并发PIH/PE,肥胖型PCOS患者孕前的低SHBG、中心性肥胖都可能与孕期并发PIH/PE有关。

Risk factors for gestational hypertension/preeclampsia in obese women with polycystic ovary syndrome

Objective To explore preconception risk factors for pregnancy-induced hypertension/preeclampsia (PIH/PE) in obese women with polycystic ovary syndrome (PCOS).Methods A prospective cohort study was conducted in infertile Chinese women with PCOS who had a singleton pregnancy by ovulation induction and were followed up for 12 weeks after delivery.The patients underwent assessment of physical,endocrine,and metabolic features before ovulation induction.Results Eleven obese (28.9％) and 6 non-obese (11.1％) PCOS patients were diagnosed with PIH/PE,respectively (both P＜0.05).Logistic regression analysis showed that preconception sex hormone-binding globulin (SHBG) was the only independent risk factor for PIH/PE (OR=0.975,P＜0.05).Receiver operator characteristic (ROC) analysis indicated that the risk value ofpre-pregnancy SHBG and waist-hip ratio (WHR) was 0.883 and 0.775,respectively.Conclusion Obese PCOS women were apt to suffer PIH/PE.Preconception low SHBG levels and central obesity might be correlated with the subsequent development of preeclampsia in obese patients with PCOS.